# FAITH AND FAMILY MEDICAL PROVIDERS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720723513
- **Authorized official:** JACQUELYN BLADDICK (HUMAN RESOURCES)
- **Authorized official phone:** (479) 310-5206

## Contact information

- **Practice address:** 363 HIGHWAY 371 S, MAGNOLIA, AR 71753-8960
- **Practice address phone:** (573) 202-4070
- **Mailing address:** 363 HIGHWAY 371 S, MAGNOLIA, AR 71753-8960
- **Mailing address phone:** (479) 310-5206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261QA0005X | Ambulatory Family Planning Facility | — | — | — |
| 261QF0050X | Non-Surgical Family Planning Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 05/05/2022
- **Last updated:** 07/11/2022